Touchstone Mental Health 26, 2013 Touchstone Mental Health 1925 Nicollet Ave S Minneapolis, MN 55403 Dear Lynette, Enclosed are the 2012 Exempt Organization returns, as

Download Touchstone Mental Health  26, 2013 Touchstone Mental Health 1925 Nicollet Ave S Minneapolis, MN 55403 Dear Lynette, Enclosed are the 2012 Exempt Organization returns, as

Post on 14-Apr-2018

214 views

Category:

Documents

2 download

Embed Size (px)

TRANSCRIPT

  • STATEMENT THAT THIS IS A TAX RETURN NOT A FINANCIAL STATEMENT

    The accompanying federal income tax return does NOT constitute a financial statement. We have not audited, reviewed or compiled the accompanying income tax return and, accordingly, do not express an opinion or any other form of assurance on it. An income tax return is not intended to constitute financial statements prepared in accordance with generally accepted accounting principles. Accordingly, it does not necessarily include all financial information or disclosures required by generally accepted accounting principles. If the omitted financial information or disclosures were included with the tax return, they might influence the users conclusions about the taxpayers financial position, results of operations and cash flows. Accordingly, this income tax return is not designed to be used in lieu of financial statements.

    RECORD RETENTION Our policy is to dispose of our copies of tax returns and workpapers, and other tax information that is more than eight years old. Your responsibility for retention of your own tax records varies, depending upon the type of tax return or other information involved. We suggest that you keep your tax information and supporting documents for a minimum of eight years. We also recommend that you keep all records that pertain to a carryover amount, such as net operating loss carryovers and charitable contribution carryovers as well as capital loss carryovers, until eight years after the carryover has been consumed. Also, we suggest that you maintain, indefinitely, copies of income tax returns, records supporting your tax basis in your personal, investment, and business assets, and documentation pertaining to gifts that you make. Your copies of the returns are enclosed for your files. We suggest that you retain these copies indefinitely.

    Touchstone Mental Health

    RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX FORM

    YEAR ENDED DECEMBER 31, 2012

  • March 26, 2013

    Touchstone Mental Health1925 Nicollet Ave SMinneapolis, MN 55403

    Dear Lynette,

    Enclosed are the 2012 Exempt Organization returns, asfollows...

    2012 FORM 990

    2012 MINNESOTA ANNUAL REPORT

    2012 IRS E-FILE SIGNATURE AUTHORIZATION FOR AN EXEMPTORGANIZATION (FORM 8879-EO)

    Please review the return for completeness and accuracy.

    We recommend that you use certified mail with post markedreceipt for proof of timely filing.

    In addition, the enclosed CD includes a public disclosurecopy of the Form 990. An exempt organization is required tohave a copy of its current year Form 990 and two prior yearreturns available for public inspection. If the returnincludes a Schedule of Contributors (Schedule B), we haveremoved the names and addresses of contributors from thisreturn as this information is not open to public inspection.The Pension Protection Act of 2006 also requires Form 990-Tto be open for public inspection for organizations exemptunder Section 501(c)(3). You should sign this copy of thereturn and keep it available at your primary office location.

    We have prepared the return from information you furnished uswithout verification. Upon examination of the return by taxauthorities, requests may be made for underlying data. Wetherefore recommend that you preserve all records which youmay be called upon to produce in connection with suchpossible examinations.

    The state of Minnesota requires that certain entities,(Corporations, Limited Liability Companies, Limited LiabilityPartnerships etc.), that receive their separate lives from

  • the state, make annual or other periodic filings to maintaintheir legal status. A failure to make these filings canresult in loss of status as a separate legal entity. A lossof separate legal status can result in significant tax andlegal ramifications. Taxable liquidation, and loss of legalliability protection can both stem from delayed filing ofperiodic registrations. Furthermore, other jurisdictions mayrequire that registrations be made to gain access to theirlegal systems for purposes of bringing suit for collection,legal liability protection, and other matters. The filing ofthese registrations is a legal matter and as such is notwithin the scope of Eide Bailly's accounting and taxpractice. Eide Bailly LLP can not, and will not, beresponsible for making sure that you have fully complied withMinnesota's or other jurisdictions' legal filingrequirements. In the past we may have completed one or moreof these forms for you in the process of preparing yourincome tax returns. We have not completed any of thesefilings for you this year. You will be responsible forcompleting any current or future required filings. TheMinnesota Secretary of State has a website where most filingscan be done on-line. The website is located at:https://online.sos.state.mn.us/abr/corp_annual_filing.asp.Legal counsel should be contacted if you are unsure of whatfiling requirements you may have.

    We sincerely appreciate the opportunity to serve you. Pleasecontact us if you have any questions concerning the taxreturn.

    Sincerely,

    Kim Hunwardsen, CPA

  • 20094105-01-12

    ~~~~~~~~~~~~~~~~~

    FOR THE YEAR ENDING

    Prepared for

    Prepared by

    Amount dueor refund

    Make checkpayable to

    Mail tax returnand check (ifapplicable) to

    Return must bemailed onor before

    SpecialInstructions

    TAX RETURN FILING INSTRUCTIONS

    FORM 990

    December 31, 2012

    Touchstone Mental Health1925 Nicollet Ave SMinneapolis, MN 55403

    Eide Bailly LLP800 Nicollet Mall, Ste. 1300Minneapolis, MN 55402-7033

    Not applicable

    Not applicable

    Not applicable

    Not applicable

    This return has qualified for electronic filing. After youhave reviewed the return for completeness and accuracy,please sign, date and return Form 8879-EO to our office. Wewill transmit the return electronically to the IRS and nofurther action is required. Return Form 8879-EO to us by May15, 2013.

  • Checkifself-employed

    OMB No. 1545-0047

    Department of the TreasuryInternal Revenue Service

    Check ifapplicable:

    AddresschangeNamechangeInitialreturn

    Termin-atedAmendedreturn Gross receipts $

    Applica-tionpending

    232001 12-10-12

    Beginning of Current Year

    Paid

    Preparer

    Use Only

    Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lungbenefit trust or private foundation)

    Open to Public Inspection

    A For the 2012 calendar year, or tax year beginning and ending

    B C D Employer identification number

    E

    G

    H(a)

    H(b)

    H(c)

    F Yes No

    Yes No

    I

    J

    K

    Website: |

    L M

    1

    2

    3

    4

    5

    6

    7

    3

    4

    5

    6

    7a

    7b

    a

    b

    Ac

    tivi

    tie

    s &

    Go

    vern

    an

    ce

    Prior Year Current Year

    8

    9

    10

    11

    12

    13

    14

    15

    16

    17

    18

    19

    Re

    ven

    ue

    a

    b

    Ex

    pe

    ns

    es

    End of Year

    20

    21

    22

    Sign

    Here

    Yes No

    For Paperwork Reduction Act Notice, see the separate instructions.

    |

    (or P.O. box if mail is not delivered to street address) Room/suite

    Are all affiliates included?

    )501(c)(3) 501(c) ( (insert no.) 4947(a)(1) or 527

    |Corporation Trust Association OtherForm of organization: Year of formation: State of legal domicile:

    |

    |

    Net

    Ass

    ets

    orFu

    nd B

    alan

    ces

    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is

    true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

    Signature of officer Date

    Type or print name and title

    Date PTINPrint/Type preparer's name Preparer's signature

    Firm's name Firm's EIN

    Firm's address

    Phone no.

    Form

    The organization may have to use a copy of this return to satisfy state reporting requirements.

    Name of organization

    Doing Business As

    Number and street Telephone number

    City, town, or post office, state, and ZIP code

    Is this a group return

    for affiliates?Name and address of principal officer:

    If "No," attach a list. (see instructions)

    Group exemption number |

    Tax-exempt status:

    Briefly describe the organization's mission or most significant activities:

    Check this box if the organization discontinued its operations or disposed of more than 25% of its net assets.

    Number of voting members of the governing body (Part VI, line 1a)

    Number of independent voting members of the governing body (Part VI, line 1b)

    Total number of individuals employed in calendar year 2012 (Part V, line 2a)

    ~~~~~~~~~~~~~~~~~~~~

    ~~~~~~~~~~~~~~

    ~~~~~~~~~~~~~~~~

    Total number of volunteers (estimate if necessary)

    Total unrelated business revenue from Part VIII, column (C), line 12

    Net unrelated business taxable income from Form 990-T, line 34

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    ~~~~~~~~~~~~~~~~~~~~

    Contributions and grants (Part VIII, line 1h) ~~~~~~~~~~~~~~~~~~~~~

    Program service revenue (Part VIII, line 2g) ~~~~~~~~~~~~~~~~~~~~~

    ~~~~~~~~~~~~~Investment income (Part VIII, column (A), lines 3, 4, and 7d)

    Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) ~~~~~~~~

    Total revenue - add lines 8 through 11 (must equal Part VIII, column (A), line 12)

    Grants and similar amounts paid (Part IX, column (A), lines 1-3)

    Benefits paid to or for members (Part IX, column (A), line 4)

    Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10)

    ~~~~~~~~~~~

    ~~~~~~~~~~~~~

    ~~~

    Professional fundraising fees (Part IX, column (A), line 11e)

    Total fundraising expenses (Part IX, column (D), line 25)

    ~~~~~~~~~~~~~~

    Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e)

    Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25)

    Revenue less expenses. Subtract line 18 from line 12

    ~~~~~~~~~~~~~

    ~~~~~~~

    Total assets (Part X, line 16)

    Total liabilities (Part X, line 26)

    Net assets or fund balances. Subtract line 21 from line 20

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~

    May the IRS discuss this return with the preparer shown above? (see instructions)

    LHA Form (2012)

    Part I Summary

    Signature BlockPart II

    990

    Return of Organization Exempt From Income Tax990 2012

    ==

    999

    X TOUCHSTONE MENTAL HEALTH41-1920740

    1925 NICOLLET AVE S 612-874-64094,770,842.

    MINNEAPOLIS, MN 55403MARTHA LANTZ X

    SAME AS C ABOVEX

    WWW.TOUCHSTONEMH.ORGX 1982 MN

    PROVIDES PROGRAMS TO ASSUREPEOPLE LIVING WITH MENTAL ILLNESS ENJOY THE HIGHEST QUALITY OF LIFE.

    99

    105120.0.

    630,271. 52,035.4,588,574. 4,700,624.

    9,426. 10,632.-11,293. 565.

    5,216,978. 4,763,856.0. 0.0. 0.

    3,186,268. 3,487,482.62,500. 36,000.

    166,599.1,218,637. 1,186,806.4,467,405. 4,710,288.749,573. 53,568.

    2,982,720. 3,143,167.262,468. 363,973.

    2,720,252. 2,779,194.

    MARTHA LANTZ, EXECUTIVE DIRECTOR

    KIM HUNWARDSEN, CPA KIM HUNWARDSEN, CPA 03/26/13 P00484560EIDE BAILLY LLP 45-0250958800 NICOLLET MALL, STE. 1300MINNEAPOLIS, MN 55402-7033 612-253-6500

    X

  • Code: Expenses $ including grants of $ Revenue $

    Code: Expenses $ including grants of $ Revenue $

    Code: Expenses $ including grants of $ Revenue $

    Expenses $ including grants of $ Revenue $

    23200212-10-12

    1

    2

    3

    4

    Yes No

    Yes No

    4a

    4b

    4c

    4d

    4e Total program service expenses

    Form 990 (2012) Page

    Check if Schedule O contains a response to any question in this Part III

    Briefly describe the organization's mission:

    Did the organization undertake any significant program services during the year which were not listed on

    the prior Form 990 or 990-EZ?

    If "Yes," describe these new services on Schedule O.

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    Did the organization cease conducting, or make significant changes in how it conducts, any program services?

    If "Yes," describe these changes on Schedule O.

    ~~~~~~

    Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses.

    Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and

    revenue, if any, for each program service reported.

    ( ) ( ) ( )

    ( ) ( ) ( )

    ( ) ( ) ( )

    Other program services (Describe in Schedule O.)

    ( ) ( )

    Form (2012)

    2Statement of Program Service AccomplishmentsPart III

    990

    J

    TOUCHSTONE MENTAL HEALTH 41-1920740

    X

    TOUCHSTONE MENTAL HEALTH IS A CENTER OF EXCELLENCE PROVIDING QUALITYPROGRAMS TO ASSURE PEOPLE LIVING WITH MENTAL ILLNESS CAN ENJOY THEHIGHEST QUALITY OF LIFE.

    X

    X

    1,126,014. 1,298,165.TOUCHSTONE RESIDENTIAL TREATMENT IS AN INTENSIVE RESIDENTIAL TREATMENTSERVICE PROVIDING CONSISTENT 24-HOUR SERVICE, 7 DAYS A WEEK. THESERVICE IMPLEMENTS AN INTEGRATED TREATMENT APPROACH GUIDED BY THEDEVELOPMENT OF AN INDIVIDUALIZED AND MEANINGFUL TREATMENT PLAN FOCUSINGON RECOVERY GOALS.

    997,592. 1,130,379.TOUCHSTONE ASSISTED LIVING APARTMENTS IS A COMMUNITY ALTERNATIVE FORDISABLED INDIVIDUALS WHICH OFFERS LONG-TERM HOUSING HELPING CLIENTSMAINTAIN STABILITY THROUGH SUPPORTIVE SERVICES.

    730,686. 844,782.TOUCHSTONE INTENSIVE COMMUNITY REHABILITATION SERVICES OFFER CLIENTS AMULTIDISCIPLINARY TEAM THAT INCLUDES A CORE GROUP OF CLINICIANS THATWORK WITH CLIENTS TO IDENTIFY PERSONAL RECOVERY GOALS AND DEVELOP AREHABILITATION PLAN TO MEET THOSE GOALS.

    1,410,492. 1,427,298.4,264,784.

    2

  • 23200312-10-12

    Yes No

    1

    2

    3

    4

    5

    6

    7

    8

    9

    10

    11

    12

    13

    14

    15

    16

    17

    18

    19

    20

    1

    2

    3

    4

    5

    6

    7

    8

    9

    10

    Section 501(c)(3) organizations.

    a

    b

    c

    d

    e

    f

    a

    b

    11a

    11b

    11c

    11d

    11e

    11f

    12a

    12b

    13

    14a

    14b

    15

    16

    17

    18

    19

    20a

    20b

    a

    b

    a

    b

    If "Yes," complete Schedule ASchedule B, Schedule of Contributors

    If "Yes," complete Schedule C, Part I

    If "Yes," complete Schedule C, Part II

    If "Yes," complete Schedule C, Part III

    If "Yes," complete Schedule D, Part I

    If "Yes," complete Schedule D, Part IIIf "Yes," complete

    Schedule D, Part III

    If "Yes," complete Schedule D, Part IV

    If "Yes," complete Schedule D, Part V

    If "Yes," complete Schedule D,Part VI

    If "Yes," complete Schedule D, Part VII

    If "Yes," complete Schedule D, Part VIII

    If "Yes," complete Schedule D, Part IXIf "Yes," complete Schedule D, Part X

    If "Yes," complete Schedule D, Part XIf "Yes," complete

    Schedule D, Parts XI and XII

    If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optionalIf "Yes," complete Schedule E

    If "Yes," complete Schedule F, Parts I and IV

    If "Yes," complete Schedule F, Parts II and IV

    If "Yes," complete Schedule F, Parts III and IV

    If "Yes," complete Schedule G, Part I

    If "Yes," complete Schedule G, Part IIIf "Yes,"

    complete Schedule G, Part IIIIf "Yes," complete Schedule H

    Form 990 (2012) Page

    Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    Is the organization required to complete ?

    Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for

    public office?

    ~~~~~~~~~~~~~~~~~~~~~~

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    Did the organization engage in lobbying activities, or have a section 501(h) election in effect

    during the tax year?

    Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or

    similar amounts as defined in Revenue Procedure 98-19?

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    ~~~~~~~~~~~~~~

    Di...

Recommended

View more >